Skip to main content

Full text of "Sector performance report: Biomedical waste inspections in hospitals"

See other formats


Sector Performance Report 



Biomedical Waste Inspections in 

Hospitals 



Ontario Ministry of the Environment 
PIBS 7391e 



October 2009 




Executive Summary 

The Ministry of the Environment conducted inspections of 47 hospitals from 
October 2007 to January 2008. The hospitals were assessed for compliance 
with the ministry's regulatory requirements for waste management (Reg. 
347) as they pertain to pathological waste, and conformance with the 
ministry's guidelines for handling biomedical waste (Guideline C-4 — The 
Management of Biomedical Waste in Ontario and Guideline C-17 — Non- 
Incineration Technologies for Treatment of Biomedical Waste). 

The facilities were selected randomly and were located across the province. 
The inspection results of the 47 facilities revealed that hospitals were 
generally responsible in their handling of biomedical waste. During the 
inspections the following issues were identified: 

- Contraventions of legislation were generally administrative in nature; 

- Manifest weight discrepancies in amounts shipped and received were 
due to inaccurate estimates (no evidence of waste lost during 
shipments); and 

- Non-conformance with guideline C-4 with regard to handling and/or 
storage of biomedical waste was largely administrative in nature. 

Four of the 47 facilities were treating biomedical waste on-site at the time of 
the inspections. The inspection results of these four facilities revealed that: 

- All four facilities were found to be in non-conformance with one or 
more of the best management practices for the treatment of biomedical 
waste found in guidelines C-4 and C-17; and 

- Non-conformance issues were generally related to record keeping and 
verification testing. 

As of June 2009, all hospitals had addressed the issues identified during the 
inspections and have taken the appropriate corrective action. 




1.0 Introduction 

As part of its proactive inspection program, the ministry conducted 
inspections across the hospital sector to evaluate environmental compliance 
and to review the use of established best management practices (i.e., beyond 
compliance) with respect to biomedical waste. The goal of the inspections 
was to reduce risk by encouraging the proper handling and storage of 
biomedical waste. 

This report provides the ministry's inspection findings and corrective actions 
taken with regard to biomedical waste in hospitals. 

2.0 Sector Profile 

Hospitals are classified under the North American Industry Classification 
System (NAICS) as part of the general medical and surgical hospitals sector 
(NAICS 62211). This includes facilities such as licensed hospitals primarily 
engaged in providing diagnostic and medical treatment to in-patients with 
any of a wide variety of diseases or medical conditions. These establishments 
can also provide other services, such as out-patient services, clinical 
laboratory services and pharmacy. 

Hospitals currently generate the largest amount of registered pathological 
waste in Ontario, producing approximately 30 percent of the total 
pathological waste shipped and recorded in the Hazardous Waste 
Information Network (HWIN) system. 




3.0 Legislative/Regulatory Context 

In general, Reg. 347 under the Environmental Protection Act regulates waste 
generation, transport and management in Ontario. Under Reg. 347, subject 
waste includes pathological waste. The regulation includes requirements for 
the registration and manifesting of the pathological waste generated by 
hospitals. 

Although not defined in Reg. 347, biomedical waste is defined in the 
ministry's guideline "C-4 — The Management of Biomedical Waste in 
Ontario". The C-4 guideline contains recommendations for best management 
practices when generating and handling biomedical waste. In addition to the 
C-4 guideline, those facilities treating biomedical waste on-site are 
encouraged to follow the recommendations in the ministry's guideline "C-17 — 
Non-incineration technologies for treatment of biomedical waste (procedures 
for microbiological testing)." 

Appendix A contains a glossary of terms used in this report. Appendix B 
contains a summary of compliance and conformance issues identified during 
the inspection sweep. Appendix C contains facts and figures regarding 
pathological and biomedical waste in Ontario. Appendix D contains a list of 
facilities inspected in the biomedical waste — hospital sector (2007/08). 




4 



Waste Types 



Reg. 347 



Pathological waste is a 

hazardous waste; requires 
registration, manifesting and 
disposal at approved facilities 



Biomedical waste is 

not defined in the 
regulation 



Waste generated from 
professional offices of d< 
dentists is excluded fr 
registration and manifi 



Pathological waste includes any 
part of the human body, and any 
part of an animal carcass and non- 
anatomical waste infected with 
communicable disease 

Anatomical waste is any Wrt of the 
human body (or part of an aimnal 
carcass), including tissues ancH^djly 
fluids, but excluding fluids, extra 
teeth, hair, nail clippings and the If 
that are not infectious 




Guidelines C-4 
and C-17 

Defines biomedical waste and 

identifies how to treat and dispose 
of each waste type 

aste generated from 
'essional offices of doctors and 
,sts is included 

omedical waste 

i^ludes, among other 
tiwgs, waste that is 
rated by human or 
al health care 
ties, medical research 
edical teaching 
ical waste from 
cilities is limited to 
uch as pathological 
(including human 
ariHomical waste and infected 
lal waste) 

other biomedical waste 

ed waste e.g., blood/bodily fluid 
'andages and consumables, sharps 
es and syringes), contaminated 
edical consumables, microbiological waste 
e.g., laboratory cultures or specimens 




4.0 Biomedical Waste Guidelines 

GUIDELINE C-4 The Management of Biomedical Waste in Ontario outlines 
special requirements and guidance on best practices for the segregation, 
storage, handling, packaging, transportation, treatment and disposal of 
biomedical wastes. Examples of best practices include: 

• Segregation - biomedical waste should be placed in separate 
containers from other hospital waste and sharps must be stored in 
separate puncture resistant containers; 

• Storage - anatomical waste should be refrigerated and temperature 
controlled and biomedical waste storage areas should be kept locked and 
be physically separate from food preparation areas; 

• Transportation - plastic bags should be placed in rigid outer 
containers for transportation off- site and reusable outer containers should 
be cleaned with a disinfecting solution prior to each use; and 

• Treatment and Disposal - anatomical waste of human or animal 
origin which has come into contact with an individual being treated for or 
suspected to be infected with one or more of the agents listed in Schedule 
5B of guideline C-4 and cytotoxic waste should be incinerated while 
disinfection methods may be used to treat other biomedical waste (see 
Section 5.0) 

GUIDELINE C-17 - Non-Incineration Technologies for Treatment of 
Biomedical Waste outlines special requirements to ensure that non- 
incineration technologies are capable of sterilizing or adequately disinfecting 
biomedical waste. 

• Includes procedures for commissioning and testing equipment; 

• For commercial operators the guideline is typically applied through 
conditions within a Certificate of Approval (C of A) for new or upgraded 
biomedical waste treatment; and 

• Waste Disposal Site Cs of A are typically not required for on site 
processing of hospital waste. 




6 



5.0 Treatment and Disposal Options 

There are three treatment and disposal options in guideline C-4: 

• Incineration - off site disposal only 

- Anatomical waste of human or animal origin which has come 
into contact with an individual being treated for or suspected 
to be infected with one or more of the agents listed in Schedule 
5B of guideline C-4 or cytotoxic (e.g., chemotherapy drugs) 
waste 

- Incineration technology used must meet Guideline A-l 
(Combustion, Air Pollution Control and Monitoring 
Requirements for Biomedical Waste Incineration....) where 
the requirements are incorporated as conditions into a 
Certificate of Approval 

• Non-Incineration - on or off site, treat waste prior to disposal 
at municipal waste sites 

- All other biomedical waste (e.g., sharps) 

- Technology should be capable of sterilizing or adequately 
disinfecting biomedical waste and is subject to Guideline C-17 
Non- Incineration Technologies for Treatment of Biomedical 
Waste; requires verification and commissioning testing 

- Treated biomedical waste may be disposed of at a non- 
hazardous waste landfill but must be managed separately from 
other non-hazardous waste. 

• Discharge to sanitary sewer 

- Blood, blood products or body fluids from the waste generation 
facility may be discharged into a sewage works 

- Subject to the Ontario Water Resources Act or established 
before April 3, 1957 or sewage system as defined by Part VIII 
of the EPA 




6.0 Inspection Program 

SCB completed 47 inspections of hospitals in Ontario from October 2007 to 
January 2008. Hospitals were assessed for: 

- Compliance with the ministry's regulatory requirements for waste 
management (Reg. 347) as they pertain to pathological waste, and 

- Conformance with the ministry's guidelines for handling biomedical 
waste 

- Guideline C-4 - The Management of Biomedical Waste in 
Ontario 

- Guideline C-17 — Non-Incineration Technologies for Treatment 
of Biomedical Waste 

Typical examples of violations of Reg. 347 noted during the inspections 
included: 

- Failure to properly register wastes; 

- Improper disposal of pharmaceutical waste; 

- Failure to maintain adequate records of waste stored on site; and 

- Administrative errors made on manifesting documents. 

A more detailed list of contraventions can be found in Appendix B. 

Typical examples of Guideline C-4 non-conformance noted during the 
inspections included: 

- Improper colour coding of waste types; 

- Biomedical waste stored at higher than recommended temperature; 

- Improper signage in waste storage areas; 

- Failure to retain records regarding verification testing for treatment 
equipment; and 

- Failure to separate treated biomedical waste from the general waste 
stream. 

A more detailed list of non-conformance issues can be found in Appendix B. 




8 



Where issues were identified, ministry inspectors provided notification to the 
hospital. As of June 2009, all issues identified during the inspections have 
been addressed by the hospitals. 

The inspection program also included an outreach component. Outreach had 
two aspects: 

- To educate hospitals on Guideline C-4; although the C-4 guidelines 
are not regulatory requirements, they represent best management 
practices; and 

- To provide immediate and direct feedback to hospitals on compliance 
with Reg. 347 as well as conformance with Guideline C-4. 



Biomedical Inspection Locations - Hospitals 



Ltgtna 

Bkjnwdicall napecilofi 

RmijIIi 

• ^SH MOEDntrictfeaH 

O 

• Foil 




Figure 1 - Locations of hospitals inspected by SCB in 2007/08. 




9 



7.0 Summary 

The results and findings of the 2007/2008 inspection sweep of the hospital 
sector by SCB are as follows: 

i. Hospitals were aware of the ministry requirements and guidelines for 
the management of pathological/biomedical waste contained in Reg. 
347, guideline C-4 and guideline C-17. Hospitals were generally 
responsible in their management and care of biomedical waste, 
ii. There was a high rate of overall non-compliance/non-conformance — 98 
per cent; however, the non-compliance/non-conformance was mainly 
administrative in nature such as improper generator registration, 
improper manifests and improper storage/labeling of biomedical waste; 
hi. Significant non-conformance was identified in the segment of hospitals 
conducting on-site treatment (four hospitals): 

a. Not properly separating treated biomedical waste from the 
general waste stream prior to disposal (Note: treated biomedical 
waste is considered non-hazardous but should be kept separate) 

b. Not fully conforming with the requirements of C-17 (i.e. could 
not produce records of commission or maintenance on request) 

iv. Manifesting discrepancies in the amount of waste shipped from 
hospitals to that received for treatment/disposal was a result of 
inaccurate estimates of waste being shipped by hospitals on their 
manifesting documents. Reg. 347 does not require that actual weights 
be taken prior to shipment. 

v. As a result of the inspection sweep the ministry has: 

a. Increased compliance/conformance rates with regulations and 
guidelines at hospitals inspected; 

b. Increased awareness of best management practices as 
documented in ministry guidelines; 

c. Identified effective management practices at hospitals; and 

d. Identified possible areas for improvement in the ministry's 
policy, guidance and regulatory framework. Information 
gathered during this inspection sweep has been utilized in the 
drafting of the ministry's current proposal to revise guideline 
C-4. 




10 



Appendix A. 

Glossary of Terms 

□ Inspection: An on-site assessment of a regulated person, business or 
other entity (i.e. vehicle) by an inspector for the purpose of assessing 
compliance with environmental law. This must occur at the location of 
the regulated activity (fixed or mobile) to ensure that the potential for 
identifying violations exists. 

□ Non-compliance: contravention of an Act or regulation or not complying 
with the terms of an order, license or Certificate of Approval. 

□ Non-compliance Rate: The proportion of inspected entities within a 
sector that had at least one violation. (Administrative Fails + 
Fails)/Inspections. 

□ Non-conformance: failure to follow best management practices 
identified in a ministry guideline such as C-4 or C-17 

□ Pass: An inspection where no legislative violations were identified. The 
company is considered to be in compliance. 

□ Administrative Fail (Admin. Fail): An inspection where legislative 
violations were identified and/or a legislative authority was applied (e.g. 
Provincial Officer Order issued). The company is not in compliance but 
there are no indications of potential for human health impact or 
environmental impairment. 

□ Fail: An inspection where legislative violations were identified and/or a 
legislative authority was applied (e.g. Provincial Officer Order issued). 
The company is not in compliance and there is/are indication(s) of 
potential for human health impact or environmental impairment. 

□ Notice of Violations: Written warning to the inspected company, 
advising the company of actions it should take to come into compliance. 
Upon receipt of a Notice of Violation, it is up to the facility to ensure that 
the necessary measures are taken to achieve compliance. 

□ Referral of companies to the Ministry of the Environment's 
Investigations and Enforcement Branch (IEB): Potentially serious 
cases are referred to the IEB for further review and possible charges. 




11 



Appendix B. 




Overall Inspection Results 




Reg. 347 Contraventions 








Observations 


Regulation 






85 percent of hospitals 


-19(l)(a) No generator shall permit subject waste to 






were not in 


pass from the generator's control or to leave the waste 






compliance with the 


generation facility except... where the generator has 






regulation. 


completed a manifest in respect of the waste in 
accordance with the Manual and this Regulation; or Also 






76 percent of 


see:EPA|Reg347|19(l)(b) 






inspected facilities 


-23(2)(b)(i) ... the generator shall obtain from the 






had manifesting 


carrier the intact manifest, with section B completed, 






errors or kept 


and shall, (i) at the time of the transfer, complete section 






inadequate records of 


A (Generator) in accordance with the Manual, and Also 






waste stored on site. 


see: EPA| Reg347 | 23(2)(a) and 23(2)(b)(i) - 23(2)(b)(iv) 
-24(4)(b)(ii) ... the generator shall obtain from the 






Over 37 percent of 


carrier the intact manifest, with section B completed, 






facilities also failed to 


and shall, (ii) remove Copy 1 (White) and return it to the 






properly register their 


Director within three working days after the transfer, 






waste or they shipped 


and Also see: EPA | Reg347 | 24(4)(a) - 24(4)(b) 






unregistered waste. 


-18(6) Where there is a change from the information 
submitted ... generator's name, address or telephone 






One facility stored 


number, the name of the contact . . . the name of the 






waste in a damaged 


responsible official ...the generator shall submit a 






container. 


supplementary Generator Registration Report to the 
Director within 15 days. 






At least one facility 


-17.2(1) ... Subject waste must be stored, handled 






stored waste for more 


and maintained so as to prevent... leaks or spills of the 






than 90 days. 


waste, or ...damage to or deterioration of the container 
in which the waste is stored. 

-17.2(3) If ... subject waste is stored at the waste 
generation facility for more than 90 days, a notice must 
be given to the Regional Director, within five business 
days after the 90th day of storage. 




^ — !*> 

Protecting our environment. (/' wlUclMO 





12 



Guideline Non Conformance 




(C-4 - Waste Segregation) 






Observations 


Guideline 

3.1 Segregation and Packaging 






Biomedical waste routinely 


- Generators shall undertake the necessary 






being segregated from the 


steps to ensure that biomedical waste is not 






general waste stream at most 


placed in containers with other hospital wastes. 






facilities. 


- ...waste sharps (needles, scalpels, blades, 






• In an isolated incident, 


etc.), ...shall be placed into a puncture-resistant 






a vial of blood and 


leak-proof container dedicated specifically for 






tubing filled with blood 


that purpose. The sharps container shall have a 






generated from the on- 


lid which can not be removed once it has been 






site dialysis clinic was 


permanently closed. 






placed in a non 


- The sharps container must be marked with 






biomedical waste 


the universal biohazard symbol ...and labeled 






container. 


"Biomedical Waste/Dechets Biomedicaux". 






Segregation non conformance 


- Other biomedical waste shall be segregated 






was observed at 37 percent of 


into either a plastic bag or rigid container with a 






the inspected facilities 


non-removable lid and labeled "Biomedical 






• Although every hospital 


Waste/Dechets Biomedicaux". The container 






had separate sharps 


shall be capable of withstanding the weight of 






containers, 


the biomedical waste without tearing, cracking 






pharmaceutical waste 


or breaking. 






was observed being 


- All biomedical waste containers shall be 






placed in sharps 


colour-coded: 






containers at several 


■ red -- where the biomedical waste 






facilities. 


is being transported to an 






• Colour coding was not 


incineration facility; or 






universally applied. 


■ yellow -- where the biomedical 
waste is being transported to a 
non-incineration facility. 




Protecting our environment. (/' wlUclMO 





13 



Guideline Non Conformance 






(C-4 - Waste Storage) 








Observations 


Guideline 

3.2 Storage of Biomedical Waste 
- Human anatomical and animal 






87 percent of facilities did not store 


anatomical waste stored by the 






biomedical waste properly. 


generator shall be stored at a 
temperature at or below 4 degrees 






Non conformance issues included: 


Celsius. Sharps and broken glass do not 






- Fridge temperature >4°C 


require refrigerated storage. Other non- 






- Not locking storage areas 


anatomical wastes stored for greater 






- Inadequate signage 


than four days after generation shall 






- Storage with other materials 


also be stored as specified above. 






(e.g., linens, food) 


- Biomedical waste storage areas at a 
generator's site may include a 
permanent area specifically designed 
and constructed for the refrigerated 
storage of biomedical waste, or a stand- 
alone refrigeration/freezer unit... It is 
essential that biomedical waste storage 
areas are kept locked, except where 
authorized personnel are on hand. 

- The facility shall be clearly marked as 
being a biomedical waste storage area 
with a sign that is no smaller than 20 
cm by 20 cm and which states 
"biomedical waste storage area" and 
"site d'entroposage des dechets 
biomedicaux" and has the universal 
biohazard symbol... clearly displayed. 

- Biomedical waste storage areas shall be 
physically separate from food 
preparation or supply areas of the 
facility. No materials other than 
biomedical waste shall be stored in the 
facility. 




Protecting our environment. (/' wlUclMO 





14 



Guideline Non- Conformance 






(C-4 - Treatment and Disposal) 








Observations 


5.0 Treatment and Disposal of 






Most facilities were properly handling 


Biomedical Waste 






and disposing of untreated biomedical 


5.1 Incineration 






waste. 


...incineration technologies shall be used 






- All hospitals had contracts with 


to treat anatomical waste... suspected to 






licensed carriers to haul biomedical 


be infected . . . 






waste to an approved hazardous 


5.2 Non-incineration 






waste disposal site. 


Non-incineration technologies may be 






100 percent of the hospitals treating 


used to treat other biomedical wastes 






their own waste (four hospitals) did not 


5.3 Discharge to Sanitary Sewer 






conform with the requirements for on- 


... may discharge blood, blood products 






site treatment and disposal of treated 


or body fluids ... into a sewage works 






waste. (Note: treated biomedical waste 








may be disposed of at municipal sites but 


6.0 Biomedical Waste Treatment 






must be handled separately) 


Facilities 






Non-conformance issues for treated 


6.1 On-Site Treatment 






waste included: 


...must keep a written record... of 






- Not properly separating treated 


biomedical waste treated... for two years 






biomedical waste from the general 








waste stream prior to disposal. At 


7.0 Final Disposal of Treated Biomedical 






three of the four facilities treated 


Waste 






biomedical waste was co-mingled 








with solid non-hazardous waste in 


7.1 Packaging for Final Disposal 






a 40 yard compactor. 


Treated biomedical waste... stored 






- Failure to produce records of 


separately from biomedical waste and 






treated waste upon request. 


other municipal waste... 




Protecting our environment. (/' wlUclMO 





15 



Guideline Non- Conformance 

(C-17 - Treatment and Disposal) 



Observations 

In addition to not conforming with C-4, 
no hospital treating waste was in full 
conformance with Guideline C-17 (e.g., 
could not produce records of commission 
or maintenance on request) 



6.0 Records And Reports 

a) A report on commission testing shall 
be prepared and retained. 

b) The complete commission testing 
procedure for the equipment must be 
retained. 

c) A report on each occurrence of 
verification testing (including recording 
and charts for the operation parameters) 
shall be prepared and retained for 2 
years. 

d) The complete verification testing 
procedure for the equipment, which is to 
contain similar information to the 
commissioning procedure, and including 
any modifications made to the procedure, 
must be retained. 

e) A record of all maintenance shall be 
prepared and maintained. 

f) Unless specified otherwise, any report 
or other document which is to be 
retained, shall be retained for the life of 
the equipment. 

g) A copy of any report or other 
document which is to be retained, shall 
be available on request to the Ministry of 
the Environment. 




16 



Appendix C 

Biomedical Waste and Pathological Waste Facts 

What is Biomedical Waste? 

Biomedical Waste includes human and animal anatomical waste and certain 
non-anatomical waste that is generated by human or animal health care 
facilities, medical research and medical teaching establishments, health care 
teaching establishments, clinical testing or research laboratories, 
professional offices of doctors, dentists, veterinarians, mortuaries, funeral 
establishments and from mobile health care activities. 

Examples of biomedical waste are: 

-Soiled waste, e.g., blood/bodily fluid soaked bandages and consumables 

-Sharps (needles and syringes) 

-Infected animal waste 

-Contaminated medical consumables 

-Microbiological waste, e.g., laboratory cultures or specimens 

-Pathological waste (including human anatomical waste) 

What is Pathological Waste? 

Pathological waste includes: 

— Anatomical waste including any part of the human body, including 
tissues and bodily fluids, but excluding fluids, extracted teeth, hair, 
nail clippings and the like, that are not infectious. 

— Non- anatomical waste infected with a communicable disease 




17 



Note: 

- A trained technician can identify the type of waste and treatment 
required. 

- For health and safety purposes, hospitals typically consider all waste 
that comes into contact with a bodily fluid to be infectious. 

- For complete definitions contained in Regulation 347 and Guidelines C- 
4 and C-17 please refer to the regulation and guidelines. The regulation 
and the guidelines prevail where there is a discrepancy between the 
definitions in this document and those in the regulation and guidelines. 

The following facts and figures are based on an analysis of data collected by 
HWIN (2005 data): 

- Pathological waste (312P) accounts for about 1.6% of all hazardous 
waste shipped (not including liquid industrial waste); 

- There are about 2400 registered generators of pathological waste (312P) 
in Ontario that ship approximately 9-10,000 tonnes of pathological 
waste annually; 

- Hospitals are the largest group of pathological waste generators in 
Ontario, producing about 3000 tonnes (~30% of the total) of pathological 
waste annually ; and 

- Pathological waste accounts for more than 60% of the biomedical waste 
shipped. 




18 



Appendix - D 

List of facilities inspected in the Biomedical Waste - Hospital Sector 

Status as of June 10, 2009 

A. INSPECTION RESULTS: PASS 



Company Name 


Site Address 


Site Municipality 


North Bay General Hospital 


720 McLaren Street 


North Bay 



B. INSPECTION RESULTS: ADMINISTRATIVE VIOLATIONS 
AND/OR NON-CONFORMANCE ISSUES IDENTIFIED 

COMPLIANCE/CONFORMANCE ACHIEVED: 



Company Name 


Site Address 


Site Municipality 


Alexandria Marine and 
General Hospital 


120 Napier St. 


Goderich 


Brockville General Hospital 


75 Charles St. 


Brockville 


Campbellford Memorial 
Hospital 


146 Oliver Rd 


Campbellford 


Cambridge Memorial Hospital 


700 Coronation Blvd. 


Cambridge 


Carleton Place & Dist. 
Memorial Hospital 


211 Lake Avenue East 


Carleton Place 


Cornwall Community 
Hospital 


510 Second St. East 


Cornwall 


Credit Valley Hospital 


75 Watline Rd 


Mississauga 


Credit Valley Hospital 


2200 Eglinton Avenue 
West 


Mississauga 


Groves Memorial Hospital 


235 Union St. E 


Centre Wellington 


Haldimand War Memorial 
Hospital 


206 John Street 


Dunnville 


Halton Healthcare Services 


30 Derry Rd East 


Mississauga 




19 



Company Name 


Site Address 


Site Municipality 


Humber River Regional 
Hospital 


200 Church Street 


Toronto 


Humber River Regional 
Hospital 


2111 Finch Avenue 
West 


Toronto 


Joseph Brant Memorial 
Hospital 


1230 North Shore 
Boulevard East 


Burlington 


Kemptville District Hospital 


2675 Concession Rd 


Kemptville 


Kingston General Hospital 


345 College Street 
East 


Kingston 


Kirkland and District 
Hospital 


145 Government Road 
East 


Kirkland Lake 


North Bay General Hospital 


750 Scollard Street 


North Bay 


Orillia Soldiers' Memorial 
Hospital 


170 Colborne St. West 


Orillia 


Ottawa Hospital - General 
Campus 


501 Smyth Rd. 


Ottawa 


Ottawa Hospital - Riverside 
Campus 


1967 Riverside Dr. 


Ottawa 


Parkwood Hospital 


801 Commissioners Rd 
East 


London 


Queensway - Carleton 
Hospital 


3045 Baseline Road 


Nepean 


Religious Hospitallers of Saint 
Joseph of the Hotel Dieu of 
Kingston 


166 Brock St. 


Kingston 


Renfrew Victoria Hospital 


499 Raglan St. North 


Renfrew 


St. Mary's General Hospital 


911 Queens Blvd. 


Kitchener 


St. Thomas Elgin General 
Hospital 


189 Elm St. 


St. Thomas 


The Hospital for Sick 
Children 


555 University Avenue 


Toronto 




20 



Company Name 


Site Address 


Site Municipality 


The New Women's College 
Hospital 


76 Grenville Street 


Toronto 


The Religious Hospitallers of 
Hotel Dieu of St. Joseph 


1030 Ouellette 
Avenue, Second Floor 


Windsor 


The Royal Victoria Hospital of 
Barrie 


201 Georgian Drive 


Barrie 


The Royal Victoria Hospital of 
Barrie 


66 Wellington St. West 


Barrie 


The Scarborough Hospital 


78 Corporate Dr. 


Toronto 


The Scarborough Hospital 
(Grace Campus) 


3030 Birchmount Rd 


Toronto 


Toronto Grace Hospital 


650 Church St. 


Toronto 


West Park Hospital 


82 Buttonwood Ave. 


Toronto 


Windsor Regional Hospital 


1995 Lesn Ave. 


Windsor 


Windsor Regional Hospital 


1453 Prince Rd 


Windsor 


Woodstock General Hospital 


270 Riddell St. 


Woodstock 


York Central Hospital 


10 Trench St. 


Richmond Hill 


York Central Hospital 


13291 Yonge Street 


Richmond Hill 



C. INSPECTION RESULTS: SIGNIFICANT VIOLATIONS 
IDENTIFIED 

COMPLIANCE/CONFORMANCE ACHIEVED: 



Company Name 


Site Address 


Site 
Municipality 


Children's Hospital of Eastern 
Ontario 


401 Smyth Rd. 


Ottawa 


Huron District Hospital 


1112 S. Andrews Dr. 


Midland 


Kingston General Hospital. 


76 Stuart St. 


Kingston 


Ottawa Hospital - Civic 
Campus 


1053 Carling Ave. 


Ottawa 




21